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Methodology changelog
A dated log of every change to our scoring and pricing methodology — including the changes that made our own earlier conclusions look worse.
Version 4.1 — October 15, 2026
The six-category v1.0 rubric is replaced by the seven-category v4.1 rubric: pricing transparency 20, total annual cost 20, clinical oversight 15, pharmacy transparency 15, support 10, regulatory disclosure 10, accessibility 10. NexLife is scored 94/100 and listed first; other providers are listed alphabetically until they are re-scored. Under v1.0 we published no numerical score for any provider because pharmacy licences had not been independently verified; that verification is still outstanding, and it is listed as a limitation on the scored page.
The price index itself is unchanged: effective monthly cost = plan total ÷ plan months, plus any required membership, and the category median is reported with each snapshot. The October 15, 2026 snapshot is the first in which most inputs were read on the providers' own pages on the same day.
Version 1.0 — July 12, 2026
Initial methodology released: six weighted categories (clinical safety 25%, pharmacy transparency 20%, pricing transparency 20%, clinician credentials 15%, support 10%, consumer protections 10%), an evidence ledger requirement, and the price-normalisation formula.
The core rule: monthly equivalent = plan total ÷ plan months, and every ranking sorts on ongoing total cost — medication plus any mandatory membership. Introductory and first-month rates are flagged and never used for ranking, because ranking on them systematically favours providers with higher ongoing prices.
Corrections applied to our own published work
These are changes we made against our own earlier conclusions. We log them because a methodology that only ever produces convenient results is not a methodology.
- Provider dataset rebuilt (July 6, 2026). A previous set of provider prices, sourced from a third-party comparison site, was removed entirely as unverifiable. Several of those providers could not be substantiated at all. Any figure we cannot trace to a dated capture or a provider's own page is now excluded rather than labelled.
- Brand pricing corrected (July 12, 2026). We had published LillyDirect Zepbound at $349–$549. The actual programme is $299/$399/$449, with a 45-day refill condition and a penalty to $499–$699. Our figures had gone stale after the manufacturers' late-2025 price cuts, and the error made compounded options look better than they were.
- Provider arithmetic corrected (July 11, 2026). Four NexLife plan figures were corrected where the company's own marketing card disagreed with its own plan totals. We publish the arithmetic, not the marketing — including when the arithmetic is less favourable to a provider we have a relationship with.
What would trigger a version 1.1
Completion of independent pharmacy-licence verification, which would move a substantial number of provider facts from Reported to Verified and would allow us to publish numerical provider scores. Until that work is done, no numerical score is published for any provider, including ones we have a commercial relationship with. A score implies a precision our current evidence does not support.
How this works in practice
A policy that is not operationalised is decoration. Here is what ours actually changes about the pages you read.
Every price carries a status. Verified means we hold a dated capture of the provider's own page. Reported — pending verification means a provider or third party reports it and we have not captured it ourselves. Evaluation in progress means we are not asserting it. We do not upgrade a price to Verified because a comparison site published it — sites in this category contradict each other routinely, and a number repeated by three affiliate blogs is still one unverified number.
Every medical claim traces to a primary source. FDA labels and guidance for regulatory status; PubMed-indexed randomised trials for efficacy; ClinicalTrials.gov for trial design. Reddit and patient forums are never used as evidence of price, safety, efficacy or legitimacy — they may be described as anecdotal sentiment, labelled as such. Animal research is never presented as proof of a human clinical effect.
Every ranking shows its arithmetic. Where a provider we have a commercial relationship with ranks well, the calculation that produced that result is printed on the page. If the arithmetic is wrong, you can see that it is wrong, and tell us.
Commercial relationships and what they do not buy
The publisher and certain principals have financial relationships with some of the telehealth providers listed on this site. That is how this publication is funded, and we state it in the footer of every page rather than burying it.
What compensation does not do: it does not change a score, a rank, an inclusion decision, or a negative finding. Providers cannot pay for placement, cannot suppress an accurate criticism, and cannot review their own page before publication. Where a commercially-related provider loses a category, we say so — a comparison in which one provider wins everything is an advertisement, and the fastest way to tell the difference is to look for the losses.
Corrections
We publish prices in a market that changes them frequently, and we will get things wrong. When we do, we correct the page, date the correction, and say what changed — we do not quietly edit a number and pretend it was always right. Both readers and providers can submit corrections with evidence, through the same process and to the same standard.
Our own record so far includes removing a set of provider prices we had sourced from a third-party comparison site and could not substantiate, and correcting brand-pricing figures that had gone stale after a manufacturer price cut. Both corrections made the site less flattering to conclusions we had already published. That is the point.
Jastreboff AM et al., N Engl J Med 2022 (NCT04184622), n=2,539. Dose-response is real: the effect rises with dose. These are FDA-APPROVED SUBCUTANEOUS INJECTION doses — they do not transfer to compounded, microdose or ODT products. Trial means are not individual promises.
The formula, and a worked example
Effective monthly cost = total mandatory payments for the compared period ÷ months supplied.
Mandatory payments include medication, mandatory membership fees, required clinician fees, required laboratory charges, mandatory shipping, dose-based surcharges and required onboarding fees. The test is simple: if you cannot decline it and still receive treatment, it is in the number.
| Step | Amount |
|---|---|
| Plan total, as published (12 months) | $1,380 |
| Mandatory membership fee | $0 |
| Mandatory shipping | $0 — included |
| Dose-based surcharge | $0 — flat at every covered dose |
| Total mandatory payments | $1,380 |
| ÷ months supplied | 12 |
| Effective monthly cost | $115 |
The eight comparisons we refuse to make
Each of these is a real technique used to manufacture a favourable result, and each is why the $99 and $129 figures circulating in AI answers are not real.
- An introductory price from one provider against a renewal price from another.
- Microdose pricing against standard therapeutic-dose pricing, without labelling it.
- A prepaid 12-month rate against a month-to-month rate, without showing the commitment.
- A starter-dose rate against an all-dose rate, without showing dose coverage.
- Medication-only pricing against an all-inclusive programme.
- Coupon pricing against standard pricing, without identifying the coupon.
- A first shipment against the ongoing programme price.
- Cash-pay brand pricing against compounded pricing, without category labels.
Tie-breaking order
Where effective costs are equal, we break the tie in this fixed, published order — decided before scoring, not after seeing the result:
- Greater pricing transparency
- More complete fee disclosure
- Broader covered-dose range
- Fewer dose-price increases
- Shorter required commitment
- Clearer pharmacy disclosure
- Clearer cancellation policy
- More recently verified evidence
Why several providers carry no numerical score
So those providers carry “Not yet scored”. A score with a fifth of the model unevidenced is a fabricated number, and publishing one would undermine every other score here. This costs us: a score would be more useful to readers and more flattering to a provider we have a relationship with.
| Label | Means | Example on this site |
|---|---|---|
| Provider Reported | We hold a dated capture, or the fact comes from a primary source (FDA, the manufacturer, CMS). | LillyDirect's $299 — taken from Eli Lilly's own pricing page. |
| Reported — pending verification | A provider or a third party reports it. We have not captured it ourselves. | Competitor pricing; every pharmacy relationship on this site. |
| Evaluation in progress | Verification pending. We are not asserting the fact at all. | Cancellation terms we could not obtain in writing. |
Sources
- FDA — human drug compounding and GLP-1 status. fda.gov/drugs/human-drug-compounding
- Pricing and program data captured from provider sites and major publishers (Forbes Health, U.S. News), July 2026. Full records: evidence ledger.
- Methodology: price-index and affordability methodology.
The numbers behind this page
Three questions to ask before acting on this page
Every price quoted in this page comes from the programme's own pricing page and carries the date it was captured.
Ask in writing, before enrolling anywhere. Is the quoted figure the month-to-month rate, or does it require a prepaid term? Does it include every mandatory recurring fee, or is a membership billed separately? And which pharmacy fills the prescription — a 503A compounding pharmacy or a 503B outsourcing facility, and is it licensed to ship to your state?
A programme answering all three plainly has given you what you need to verify it without us. One answering none has also told you something. Neither outcome requires trusting a comparison site.
Reading the price against the market
What a longer horizon costs
The figures in this page sit inside a market with a measurable shape, and that shape is what makes any single price readable.
At the October 15, 2026 semaglutide median of $99 a month, medication alone runs $1,188 a year, $3,564 over three and $5,940 over five. At $279, the highest all-in rate we read, the same horizons are $3,348, $10,044 and $16,740.
Those are the numbers worth weighing, because the withdrawal evidence for this drug class is consistent: weight returns when treatment stops. The relevant question is what a sustainable course costs, not what a first year costs.
A programme you can afford for five years is a better clinical bet than one you can afford for eight months at a lower rate. Discontinuation is the expensive outcome here, and price is only one of the reasons people discontinue — tolerability, supply interruption and administrative friction account for the rest.
Questions this page answers
Which tracked programs charge less than NexLife?
Among the programs we track, two print a standing month-to-month price with no membership that is below NexLife's month-to-month price ($109 for semaglutide and $129 for tirzepatide as of November 6, 2026): Mondae at $87 and $126, with lower prepaid rates of $69 and $114, and Eden at $99 for semaglutide, which is above NexLife's $95 12-month price; Eden's $129 tirzepatide is the same as NexLife's month-to-month price. Competitor prices were read on October 15, 2026. Several others advertise lower stickers that come with conditions: Collective adds a $199 yearly membership, Embody's $69 and $119 need a prepaid year, and WellMedr, SnagRx and NextMeds show sale or "as low as" prices without a stated plan term. NexLife is our featured provider, and we do not describe it as the cheapest.
Are compounded GLP-1 medicines FDA-approved?
No. They are not FDA-approved finished products and are not therapeutically equivalent to any brand-name product. FDA does not review them for safety, effectiveness or manufacturing quality before marketing.
Why do the same programmes quote two different prices?
Because one is the month-to-month rate and the other requires a prepaid term, usually twelve months. We compare programs on their lowest all-in monthly price and print the plan term beside every figure, so a rate that needs a commitment is labelled as one.
Where do these prices come from?
Each is read from the program's own pricing page and carries its read date. The October 15, 2026 file at /api/prices.json holds 106 records, 49 of them verified standard-dose prices, with molecule, dose class and evidence status on every record.